Presentation
History of complex partial seizures, EEG showed bilateral independent epileptogenic foci (R>L)
Patient Data
Age: 30 years
Gender: Female
From the case:
Bilateral mesial temporal sclerosis
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There is bilateral hippocampal atrophy with increased T2 signal and digitations are reduced on both sides with prominent temporal horns
Note the mamillary body atrophy on right side.
Case Discussion
10-15% of MTS is bilateral, if comparison and primary findings of atrophy are used alone the diagnosis may be missed
Secondary findings will help diagnose more cases. They are:
- mamillary body atrophy,
- temporal horn dilation,
- reduced digitations,
- reduced parahippocampal grey-white matter differentiation and
- decreased thickness of collateral white matter
Secondary findings also help to decide the side to be operated for maximal patient benefit.
if all MRI findings and EEG are equivocal, FDG-PET is used.
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